Single Versus Combined Pharmacological Treatment of Youngsters with TS Plus Comorbid OCD-A Pilot Study

Grant Type
Grant Year
Institution Location
Institution Organization Name
McLean Hosp, Harvard Medical School
Investigators Name
Gellar, Daniel, MBBS, FRACP

Although the comorbidity between Tourette Syndrome (TS) and Obsessive-Compulsive Disorder (OCD) is well established, little information exists on the treatment of the comorbid subtype since studies of people with OCD and TS systematically exclude the comorbid group. Yet, how to treat patients with the comorbid subtype (TS+OCD) is a pressing clinical concern. To this end we propose a randomized, clinical treatment trial of clomipramine alone (N=20), paroxetine alone (N=20), and clomipramine+ paroxetine (N=20) in the treatment of pediatric TS+OCD subjects. These treatments were selected because controlled studies have documented the efficacy of tricyclic antidepressants in the treatment of youngsters with TS and of serotonergic antidepressants in the treatment of children with OCD. Considering that noradrenergic effects have been cited as relevant in the treatment of tic disorders, a drug with a combined serotonergic/noradrenergic profile such as clomipramine may be uniquely effective in the treatment of TS+OCD patients. On the other hand, because TS and OCD are considered to reflect variable expressions of the same underlying risk factor, serotonergic drugs may improve both conditions. Finally, since TS+OCD may represent a more severe form of both TS and OCD, a combined pharmacological approach may be better suited for its treatment. Answers to these important scientific questions are needed to help select the most effective treatment for a second stage future placebo-controlled clinical trial that would include both TS+OCD patients. Daniel A. Geller, M.B.B.S., F.R.A.C.P. McLean Hospital/Harvard Medical School Belmont, MA Award: $39,094 H.B. PEARL MEMORIAL AWARD Tourette Association of America Inc. – Research Grant Award 1997